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Response Elaboration Training

Efficacy of Response Elaboration Training for individuals with aphasia-apraxia of speech

Shannan O'Donnell

on 26 November 2012

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Transcript of Response Elaboration Training

Question: Is Response Elaboration Training an efficacious treatment approach for individuals with aphasic-apraxic speech? Purpose: The purpose of this study was to determine the effectiveness and the generality of Response Elaboration Training program for a patient with chronic Broca’s Aphasia Response Elaboration Training for Patient Initiated Utterances
Kevin Kearns, 1985 Method: subject was a 50 year old male with moderately severe Broca's aphasia and mild to moderate apraxia of speech

Design/ Treatment:
Multiple-baseline used across all behaviors. Two sets of ten black and white line drawings used as training items depicting actions
number of content words and if more elaborate responses generalized to familiar untrained stimuli.

Results: provided convincing evidence that loose training approach did facilitate the subject's response elaboration and increase the number of content words produced Wambaugh and Martinez, 2000
Examined the acquisition, response generalization, stimulus generalization, and maintenance effects of modified RET on speech and language production for individuals with apraxia of speech and aphasia.
Modifications for this particular study included use of integral stimulation, clinician modeling, and repeated practice of elaborated utterances

Three individuals with Broca's aphasia and mild-to severe apraxia of speech
multiple baselines used across

Results showed an increase in number of client initiated utterances in response to stimuli as well as personal recounts by all participants.
Positive stimulus generalization effects were observed
Despite using a modified version of the response elaboration training procedure, positive results were found for RET and support for the future use of this approach. Wambaugh, Martinez, and Alegre, 2001
Wambaugh, Martinez, and Alegre investigated the qualitative changes in verbal production following RET. They examined speaker’s productions using an analysis that was more detailed than those previously employed with Response Elaboration Training to determine the nature of the content words that have been produced.

This study included two male, apraxic-aphasic speakers with chronic Broca’s aphasia with moderate to severe apraxia of speech

This study showed positive results in support for the use of RET as it investigated qualitative measures of the treatment approach.
Results also indicated an increase in the production of verb and noun phrases. Discussion
Both RET and modified RET produced positive changes for number of content words and elaborated responses produced by a person with aphasia-apraxia of speech

Incorporating motor learning strategies such as those used in the modified version of RET may be beneficial in improving
verbal output

Studies found positive generalization effects following RET for individuals with aphasia-apraxia of speech

Levels of Evidence

Overall, levels of evidence were found to be lower in that the majority of the studies used single-subject designed
Not all the studies were peer-review level
Two of the studies included in this review were written by the same group of researches

Future Research could consider the effects of using multiple-baseline in that it could create a lack of experimental control
Could consider social-emotional factors that play a role in productivity

What is Response Elaboration Training??

It is a loose training technique designed for aphasia patents in order to increase the length and information content of verbal responses

How does it work??
1.Clinician elicits spontaneous response from client using picture stimuli rather than a preselected target
2. Then clinician models and reinforce initial response
3. Expand and elaborate response through scaffolding
4. Reinforces client’s attempts at elaboration
5. Repeats and expands the client’s utterance
6.Models and the expansion by scaffolding the client’s response

Idea: less structured treatment = increase in creative language use-->more content words that can be used for scaffolding longer utterances Works Cited
Edelman, G. (1987). Promoting Aphasics Communicative Effectiveness: PACE. Winslow Press.

Gaddie, A., Kearns, K. P., & Yedor, K. (1991). A qualitative analysis of response elaboration training effects.Clinical Aphasiology, 19, 171-183.

Kearns, Kevin P. Response Elaboration Training for Patient Initiated Utterances. In Clinical Aphasiology Conference: Clinical Aphasiology Conference (1985 : 15th : Ashland, OR : June 2 6, 1985) / : BRK Publishers(1985), pages 196-204.

Wambaugh, J. L., Martinez, A. L., & Alegre, M. N. (2001). Qualitative changes following application of modified response elaboration training with apraxic-aphasic speakers. Aphasiology, 15(10-11), 965-976.

Wambaugh, J. L., & Martinez, A. L. (2000). Effects of modified response elaboration training with apraxic and aphasic speakers. Aphasiology,14(5/6), 603-617.
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